AT2728
Expert
The hospital billing department and myself (I code physician) are in a heated debate with my physician. Our stance is that if the physician documents a PREOPERATIVE condition, hemorrhoids, rectal bleeding, constipation, on the operative colonoscopy report that the colonscopy should not be billed as screening. Mind you-he also lists a diagnosis of screening colonscopy as preop. He is stating that just because he lists a preoperative diagnosis that does not warrant or indicate a need for a colonoscopy. My feelings...I truly believe (especially in light of the mandated preventive insuranc coverage), that inusurance companies will argue that a preop diagnosis overides the screening and should be billed as such. I'm looking for any further documentation. This physician will argue to the death, he had some coding education YEARS ago and feels he is always correct. Our last conversation he told me that he code bill it however he wanted! What do I do with this? In some of these cases he is listing diarrhea as a preoperative diagnosis, but then I read the H&P and it clearly states that the patient had diarrhea in the past when he ate lettuce--but yet he lists this as a current condition on the operative report. So, I have an additional question----if he lists hemorrhoids (not a covered diagnosis for Medicare) should this colonoscopy be billed screening? Is there a list of specific diagnostic indications for colonoscopy---and if the symptom is not on that list should it be screeing? He's got me second quessing everything I've learned. Please Help me!
April
April